The dexamethasone/corticotropin-releasing factor test in men with major depression: Role of childhood trauma
The dexamethasone/corticotropin-releasing factor test in men with major depression: Role of childhood trauma
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DOI：
10.1016/j.biopsych.2007.07.002
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发表时间：
2008-02-15
影响因子：
10.6
通讯作者：
Nemeroff, Charles B.
中科院分区：
文献类型：
--
作者：
Heim, Christine;Mletzko, Tanja;Nemeroff, Charles B.
背景资料：地塞米松/促肾上腺皮质激素释放因子（CRF）睾丸被认为是下丘脑-垂体-肾上腺皮质（HPA）轴亢进的最敏感指标，并已被证明在重度抑郁症（MDD）患者中发生改变。虽然儿童期创伤是MDD的一个已证实的风险因素，并且有儿童期虐待史和MDD的患者表现出HPA轴活动过度，但地塞米松/CRF试验在该人群中仍未进行研究。方法：49例健康男性，年龄18-60岁，无躁狂症、精神病、药物滥用、进食障碍，无药物史，分为4组：1）正常对照组（n = 14），无儿童期滥用史或精神障碍; 2）有儿童期虐待史但目前无MDD的男性（n = 14）; 3）有儿童期虐待史但目前有MDD的男性（n = 15）;以及4）目前有MDD但无儿童期虐待史的男性（n = 6）。血浆促肾上腺皮质激素（ACTH）和皮质醇浓度测定地塞米松/CRF administration.Results：男性与儿童创伤史表现出增加ACTH和皮质醇反应地塞米松/CRF相比，非滥用男性。特别是，与对照组和没有童年虐待经历的抑郁症男性相比，目前患有MDD的受虐待男性表现出更高的反应性。反应增加与滥用的严重程度、持续时间和较早发作相关。并发创伤后应激障碍。结论：儿童期创伤增加HPA轴的活动与地塞米松/CRF测试测量成年男性MDD，可能反映环境风险发展抑郁症。
Background: The dexamethasone/corticotropin-releasing factor (CRF) testis considered to be the most sensitive measure of hypothalamic-pituitary-ad renal (HPA) axis hyperactivity and has been demonstrated to be altered in patients with major depression (MDD). Although childhood trauma is a demonstrated risk factor for MDD and patients with a history of childhood abuse and MDD demonstrate HPA axis hyperactivity, the dexamethasone/CRF test remains unstudied in this population. We determined the impact of childhood trauma on dexamethasone/CRF test results in patients with MDD.Methods: Forty-nine healthy men, ages 18-60 years, without mania or psychosis, active substance abuse, or eating disorder and medication-free were recruited into four study groups, including: 1) normal subjects with no childhood abuse history or psychiatric disorder (n = 14); 2) men with childhood abuse histories without current MDD (n = 14); 3) men with childhood abuse histories with current MDD (n = 15); and 4) men with current MDD and no childhood abuse history (n = 6). Plasma adrenocorticotropin (ACTH) and cortisol concentrations were measured in response to dexamethasone/CRF administration.Results: Men with childhood trauma histories exhibited increases in ACTH and cortisol responses to dexamethasone/CRF compared with non-abused men. In particular, abused men with current MDD showed increased responsiveness compared with control subjects and depressed men without childhood abuse experience. Increased response was associated with the severity, duration, and earlier onset of the abuse. The effects were not explained by concurrent posttraumatic stress disorder.Conclusions: Childhood trauma increases HPA axis activity as measured with the dexamethasone/CRF test in adult men with MDD, potentially reflecting environmental risk for developing depression.